Section 1: Organization Information

Organization Name

Primary Contact Name

Title/Role

Email Address

Phone Number

Website (if available)

Organization Type
Non-ProfitFor-Profit BusinessGovernment AgencyEducational InstitutionOther

Section 2: Partnership Details

How does your organization support entrepreneurs or underrepresented founders?

Which sectors or industries does your organization focus on? (Select all that apply)
TechnologyHealthtechFintechAgritechCleantechArtificial Intelligence (AI)Other

What type of partnership opportunities are you interested in? (Select all that apply)
Event CollaborationMentorship ProgramsFunding or Investment SupportAccess to Networks & ResourcesJoint Marketing & OutreachOther

Have you worked with startup or investment networks before?
YesNo

Section 3: Additional Information

How did you hear about Nexis Venture Studio?

Why do you want to partner with Nexis Venture Studio?

Anything else you’d like us to know about your organization?

Next Steps:
Once submitted, our team will review your application and reach out to discuss potential next steps.

Your Name

Your Email

Phone Number

Province

Section 1: Founder & Co-Founder Information

Your Name

Your Email

Phone Number

LinkedIn Profile

Company Website (if available)

Do you have co-founders?
Yes (please list names & roles below)No

Founder Demographics (optional, for diversity tracking):
Gender Identity:
MaleFemaleNon-binaryPrefer not to sayOther

Ethnic Background:
IndigenousBlackAsianHispanic/LatinxMiddle EasternWhiteOther

Do you identify as part of any underrepresented group (e.g., LGBTQ+, persons with disabilities)?
YesNo

Section 2: Company Details

Company Name

Company Headquarters (City & Province)

Year Founded

Company Stage
Idea StagePrototype/MVP DevelopedPre-RevenueGenerating RevenueScaling Up

Brief Description of Your Business (2-3 sentences)

Sector Focus (select all that apply)
FintechHealthtechAgritechCleantechArtificial Intelligence (AI)Other

What problem does your startup solve?

Who is your target market?

What is your unique value proposition?

Section 3: Traction & Growth

Current Monthly Revenue (if applicable)

Total Capital Raised to Date (if any)

What key milestones have you achieved? (e.g., product launches, partnerships, revenue targets, customer growth)

How many paying customers or active users do you currently have?

Have you participated in any accelerator, incubator, or mentorship programs?
YesNo

Section 4: Fundraising & Support Needs

Are you currently seeking funding?
YesNoPlanning to raise within the next 6 months

If seeking funding, what is your target amount and how will it be used?

What areas do you need the most support in? (Select all that apply)
FundingMentorshipNetworking & ConnectionsProduct DevelopmentGo-to-Market StrategyHiring & Talent AcquisitionOther

Do you currently have any advisors or mentors supporting your business?
YesNoIn the process of finding advisors

Section 5: Additional Information

How did you hear about Nexis Venture Studio?

Why do you believe Nexis Venture Studio is the right fit for your startup?

Anything else you’d like us to know about your business or your journey?

Next Steps:
Once submitted, our team will review your application and reach out to discuss potential next steps. If your startup aligns with our investment thesis, we may invite you for an introductory meeting.